Carnegie Mellon University
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Medical Plans

Eligible faculty and staff members can choose from several plan options. Learn more about the options available to you, rates, coverage and resources provided by each plan.

Eligibility

You must be full-time benefits eligible (37.5 scheduled hours per week) or part-time benefits eligible (at least 17.5 scheduled hours per week) to enroll in medical plans. Shuttle drivers and members of the Campus Police Association must be scheduled to work 40 hours per week to be full-time benefits eligible.

Enrollment Reminders

  • You must enroll within 30 days of the date you become eligible (i.e., hire date, change in employment status).
  • You can only make changes during Open Enrollment, or if you experience a qualifying life or family status change. Dependent verification is required.
  • Medical and prescription coverage go together. If you enroll in medical coverage you must also enroll in prescription coverage, and you must cover the same individuals under both plans.

Medical Plan Options

View the Medical Coverage Comparison Chart and Medical Plan Resources for more information.

Plan Type

Description
Preferred Provider Organization (PPO)

PPO plans give you the flexibility to use in- or out-of-network providers without referrals. A higher level of benefits is provided when in-network providers are used, resulting in lower out-of-pocket costs for you.

  • PPO plans are available through both Highmark and UPMC.
Health Maintenance Organization (HMO) / Exclusive Provider Organization (EPO)

HMO/EPO plans have low out-of-pocket expenses (no deductible or coinsurance) but do not provide benefits if you use out-of-network providers (except in the case of an emergency). Referrals to specialist care and related services are not required in most circumstances.

  • Plans are available through both Highmark and UPMC:
    • The UPMC HMO is available to faculty and staff in Western Pennsylvania only.
    • The Highmark EPO is available to faculty and staff at all domestic locations.
High Deductible PPO with Health Reimbursement Account

High-Deductible PPO plans have a higher deductible and a lower monthly premium. CMU funds a Health Reimbursement Account (HRA) that you can use to help pay for eligible deductible expenses. Once your health care expenses for the year exceed your deductible, the PPO plan begins paying benefits.

  • High Deductible PPO with HRA plans are frozen to current enrollees. Account balances must be spent by December 31, 2022; remaining dollars will be forfeited.
  • In 2023, CMU will offer a High Deductible PPO with Health Savings Account.

Medical Plan Summaries

Medical Plan Rates

Medical Plan Contacts and Provider Search Tools

Highmark Blue Cross/Blue Shield

UPMC Health Plan